Factitious Disorder

(Munchausen Syndrome)

Definition

Factitious disorder is a mental illness in which a person makes up an illness or injury. A person with factitious disorder may claim to have the psychological symptoms of a mental illness or the physical symptoms of a medical illness. The term Munchausen syndrome is sometimes used to refer to factitious disorder with severe physical symptoms.

In addition, factitious disorder by proxy (or
Munchausen syndrome by proxy) falls into this category. Factitious disorder by proxy involves a parent claiming their child has psychological or physical symptoms in order to get needless medical attention for the child.

Factitious disorder may be confused with another type of mental disorder called
somatoform
disorder. If a person has this disorder, then they are not pretending to be sick. The person really believes that there is something physically wrong. However, the symptoms are actually due to psychological issues.

Factitious disorder is also different from
malingering, which occurs when a person pretends to be sick for some kind of clear benefit, such as money, food, or housing.

Blocking contact between previous and current doctors, and between doctors and family members

Symptoms that appear only when person is not being observed

Demanding medical tests or procedures

Eagerness to have medical tests or procedures

Self-inflicted or artificial symptoms of disease

Diagnosis

It is difficult for a doctor to diagnosis a factitious disorder. People who have this disorder become skillful in pretending to have illnesses. The doctor also has to rule out any real physical condition that the person may have.

If the doctor determines that there is no physical cause for the symptoms, then the person may be referred to a mental health expert. This expert can then rule out other psychological conditions, like somatoform disorder and malingering. The person may become hostile and not want to work with a psychologist. However, there are strategies that the doctor can use to act in a way that is more supportive and helpful. The person can be encouraged to seek mental health treatment.

Treatment

Factitious disorder is difficult to treat. The person may resist getting help. In some cases, the person may agree to work with a mental health expert. Psychotherapy or behavior therapy may be helpful. If the person has any other conditions, like
depression,
anxiety, or
other mental health problems, these can be treated as well.

Somatic symptom and related disorders. American Academy of Family Physicians Family Doctor website. Available at:
http://familydoctor.org/familydoctor/en/diseases-conditions/somatoform-disorders.html. Updated August 2015. Accessed October 15, 2015.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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